CAJ | 학술논문

目的评价T1WI边界征及T2-FLAIR皮质征对鉴别单发转移瘤与高级别星形细胞肿瘤的价值.方法高级别星形细胞肿瘤31例和单发脑转移瘤42例,均接受常规MR平扫及增强扫描,回顾性分析边界征和皮质征的出现几率.结果 73例中39例出现T1WI边界征,其中32例为单发转移瘤,7例为星形细胞肿瘤;边界征诊断单发转移瘤的敏感度和特异度分别为76.20%和77.42%,对单发转移瘤的阳性预测值是82.05%.34例出现T2-FLAIR皮质征,其中25例为星形细胞肿瘤,9例为单发转移瘤;皮质征诊断星形细胞肿瘤的敏感度和特异度分别是80.65%和78.57%,对星形细胞肿瘤的阳性预测值是73.53%.55例只出现一个征象,其中31例仅出现边界征,其中27例为单发转移瘤,4例为星形细胞肿瘤;24例仅出现皮质征,其中21例为星形细胞肿瘤,3例为单发转移瘤.两种征象联合应用的ROC曲线下面积为0.85.结论边界征与皮质征分别是诊断脑单发转移瘤和星形细胞肿瘤较特异的征象,两者联合应用有助于提高二者的鉴别诊断准确率.
목적 평개T1WI변계정급T2-FLAIR피질정대감별단발전이류여고급별성형세포종류적개치.방법 고급별성형세포종류31례화단발뇌전이류42례,균접수상규MR평소급증강소묘,회고성분석변계정화피질정적출현궤솔.결과 73례중39례출현T1WI변계정,기중32례위단발전이류,7례위성형세포종류;변계정진단단발전이류적민감도화특이도분별위76.20%화77.42%,대단발전이류적양성예측치시82.05%.34례출현T2-FLAIR피질정,기중25례위성형세포종류,9례위단발전이류;피질정진단성형세포종류적민감도화특이도분별시80.65%화78.57%,대성형세포종류적양성예측치시73.53%.55례지출현일개정상,기중31례부출현변계정,기중27례위단발전이류,4례위성형세포종류;24례부출현피질정,기중21례위성형세포종류,3례위단발전이류.량충정상연합응용적ROC곡선하면적위0.85.결론 변계정여피질정분별시진단뇌단발전이류화성형세포종류교특이적정상,량자연합응용유조우제고이자적감별진단준학솔.
Objective To investigate the value of the boundary sign and cortex sign in differential diagnosis of solitary brain metastasis and astrocytoma. Methods Thirty-one patients with high grade astrocytoma and 42 patients with solitary brain metastasis diagnosed either pathologically or clinically were included in this study. The differential diagnostic value of the boundary and the cortex sign were analyzed retrospectively. Results The boundary sigh was found in 39 of 73 patients, which included 32 patients with solitary metastasis and 7 patients with astrocytoma. The sensitivity and specificity of the boundary sign was 76.20% and 77.42%, respectively, and the positive predictive value for solitary metastasis was 82.05%. The cortex sign was found in 34 of 70 patients, including 25 with astrocytoma and 9 with solitary metastasis. The sensitivity and specificity of the cortex sign was 80.65% and 78.57%, respectively, and the positive predictive value for astrocytoma was 73.53%. The boundary sigh was singlely foundin 24 patients, including 21 with astrocytoma and 3 with solitary metastasis. The area under the curve for both two signs was 0.85. Conclusion The boundary sign and the cortex sign are specific signs in differentiation between solitary brain metastasis and astrocytoma on routine MR series. Combination of this two signs is very useful in distinguishing solitary brain metastasis from astrocytoma.